Provider Demographics
NPI:1114699451
Name:BRINKLEY, DEBBIE A
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:A
Last Name:BRINKLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 CHESTERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-3855
Mailing Address - Country:US
Mailing Address - Phone:419-509-2395
Mailing Address - Fax:
Practice Address - Street 1:164 CHESTERFIELD LN
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-3855
Practice Address - Country:US
Practice Address - Phone:419-509-2395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor